Women with breast cancer-susceptibility 1 (BRCA1) and BRCA2 gene mutations have a significantly increased lifetime
risk of developing breast cancer, and an estimated 40% to 65% of carriers develop breast cancer by age 70 years.1
Because of their elevated risk, carriers are advised to begin routine annual breast cancer screening at younger ages with
both mammography and breast magnetic resonance imaging (MRI).2 However, there is no current consensus regarding
the optimal age to begin annual screening or whether multimodality screening should occur contemporaneously or with
alternating modalities every 6 months. In addition, concerns have been raised about the risks of earlier and repeated radiation
exposure in women who already are at increased breast cancer risk.3-5
It has been demonstrated that screening mammography decreases breast cancer mortality in the general population6,7
and that the use of screening MRI identifies cancers at smaller sizes and earlier stages in women with an increased
breast cancer risk.8 Potential disadvantages of more intensive breast cancer screening include an increased number of false